One of the most common complaints runners have is calf pain, particularly while running. It might initially come in bouts during just a couple runs, but sometimes it will stick around for weeks and months if left unaddressed. Rest usually improves this discomfort at first, but isn’t typically sufficient for long-term, consistent relief if the person continues to run and doesn’t make any other changes. They’ll complain that their calf muscles feel “tight.” And it’s common for both calf muscle groups to start to feel this way around the same time.

Some runners take the “I give up” approach and assume it’s a necessary part of getting older or running too many miles, so they begin to modify their training around it by planning an additional rest day or cross training instead. They take the “a little running is better than no running” approach, which I think is very reasonable for a true injury, but when something can be improved, why not address it the right way?

For the sake of this article let’s assume we are covering muscle-specific pain in the calf that isn’t too bothersome much outside of running. These are more likely to be muscle overuse syndromes or biomechanical overload syndromes. This cause of pain can be treated while you continue to run, if done correctly.

But there are plenty of other things that can cause calf pain and you will need a medical professional, not an internet article, to rule those out.

Possible (and Potentially Serious) Medical Issues to Rule Out

Blood clots/deep vein thrombosis

Nerve mobility deficits or irritability of the lumbar, sciatic, and tibial nerves

Calf muscle tear/rupture

Popliteal artery entrapment

What can you do?

Seek professional medical guidance if you have had a traumatic injury (often accompanied by a sudden “pop” or a feeling of being kicked in the calf). We are also very concerned if there is a more persistent or severe onset of pain, or additional symptoms like sensation changes (pins, needles, tingling, burning), fever, swelling, and redness of the calf. It’s important to consider your overall history because factors such as being older, having a history of a particular problem, recent immobilization, comorbidities, and certain medications can all have a role. These issues are very different than a mild discomfort, tightness, or fatigue that occurs only while running. It isn’t to say that some of these problems can’t be treated conservatively but you will have the best chance at success with proper diagnosis. We need to keep in mind too, if you have attempted treatment that doesn’t seem to be helping.

Other considerations:

Calf Strength and Endurance Deficits

Logic would tell you that running demands a ton of work from the leg muscles. At some routine level of activity, the muscles adapt to that work and you keep on going from week to week without issues, just as happily as ever. Now what happens if you chronically demand so much from those muscles that they can’t adapt to what you are trying to have them do? They slowly start to...change…like your best friend from junior high school. At first it was cute but two months later you were just annoyed. The muscles don’t have to be painful, at first. Maybe they just feel more tired and tight. But when you keep running on them and don’t make any other changes they become more consistently problematic.

The muscle and fascial connective tissue isn’t able to adapt to your demands in a positive manner when demand outpaces normal repair over a long period of time. Why couldn’t the muscles withstand the demand? Most likely there wasn’t enough strength or endurance (or both) in the muscle group. Given enough time of chronic repetitive stress on under-prepared tissue, the quality of the soft tissue changes.

Running really requires something called “strength endurance” from muscles like the calf. You might even better call it “strength and power endurance,” but I don’t want the top of your head to blow off right now so forget I said that. The point is that the muscles of the calf have to withstand high forces (strength), very rapidly (power), and with high frequency (endurance).

The calf-strength variations that will show up when tested during a single leg calf/heel raise are often interesting. A runner might have tons of gastrocnemius strength during a straight-knee calf raise, but when the calf raise is re-tested while the knee is flexed, they can’t reach the top end of the calf raise anymore. Often this means they have decreased soleus strength, which is a real problem since, while running, we spend a large portion of the running stride with the knee slightly bent. Or maybe they can’t perform the same amount of reps on one side when compared to the other in either position.

Even worse is when the person can’t perform any type of single leg calf raises without relying on their long toe flexing muscles that come from deep in the calf region. My heart hurts when I see this. These people tend to grip with their toes during calf raises and just can’t get their brain to shut those muscles off while completing the raise because the bigger, outer calf muscles are just that weak. It’s not a surprise that people will run with those toe muscles engaged heavily too.

What can you do?

Build the strength of the calf muscles using calf raises, with the knee slightly bent and straight, without gripping with the toes, and with just a single leg at a time. Full ankle range of motion is key. Causing calf muscle fatigue is the goal. That might take five reps or 20. Don’t hammer it to death because you’ll probably become sore for two days. Early strengthening with bodyweight is good but after 2-3 weeks of 3-4x/week, runners should be able to add extra resistance, even beginning with something like 10 pounds. The calf needs to be strong, but...

Other Strength Deficits

I am stating the obvious here, but it takes more than the calf muscles to propel a runner. Lacking hip or thigh strength could lead to a trickle-down of abnormal demand into the calf muscles. The calf could actually be super strong but just have to endure too much stress every time you go running because something else stinks at its job. End result: too much work being done by the calf muscles that leads to stress-induced discomfort.

What can you do?

Ensure you have full strength of the hip and thigh muscles (eg. gluteus maximus, gluteus medius, hamstrings, quadriceps). Strengthening exercises for these areas is beyond the scope of this article, but the point is you need to look outside the area of symptoms if you want to actually fix the problem. Remember to emphasize single-leg strengthening to ensure symmetry. If you can only do eight single leg bridges on one side and 20 on the other then you’ve got some extra work to do on the weaker side.

Neuromuscular control

Your awareness of and ability to modify the way your body moves at any given instant is a good indicator of overall athleticism. Remember, our muscles only know how to function based on what they are told by the nervous system, particularly the spinal cord. If your nervous system can’t figure out how much force to generate from the various muscles at any one moment then your movement isn’t refined. Picture a gymnast on a balance beam. It doesn’t take much error to result in falling off the beam. They really have to own their movements with precision and certainty. Kinda, sorta knowing where their feet are isn’t going to cut it. Or imagine an infant learning to crawl. They are constantly on the edge of failure until their nervous system figures out the best way to coordinate muscle contractions to keep their body stable. Your calf muscles must contract with correct amounts of other muscle contractions in that leg with every footstrike.

What can you do?

Working on drills to improve your balance and proprioception is key. As previously mentioned, single-leg work is a necessity. And I don’t mean sit on a machine to do knee extensions, calf raises or leg presses one leg at a time. When you use machines, there’s no real demand that requires the nervous system to learn how to stabilize your body. Single leg balance that progresses into single leg deadlifts, single leg squats, single leg hops, single leg box jumps, single leg calf raises, the options are many. The point is to emphasize standing on one leg while you move the rest of your body.

Foot, Ankle Structure

An individual with a more flexible foot or ankle type that allows an inward collapse of the heel bone or inner foot arch could be placing more demand on their calf. These people are generically labeled as “flat-footed.” Though the more superficial calf muscles are mainly producing force for the forward/backward sagittal plane, there are additional forces that this outer calf and much deeper calf must withstand in the side-to-side or frontal plane. And then we must consider that the deeper calf muscles, like the posterior tibialis, that help to control the side-to-side ankle and foot motion, are also notorious for being part of the cause of pain.

What can you do?

Build the strength of the muscles that assist in stabilizing the ankle and foot that also come from the lower leg, like the peroneus longus, peroneus brevis, anterior tibialis, and posterior tibialis. One way of doing this is with resistance bands. This is also why I love single leg strengthening exercises like single leg Russian deadlifts that also require a person to balance and stabilize like a circus elephant on top a ball. As discussed below, you should perform routine soft-tissue maintenance on all of the calf muscles, superficial and deep.

Here’s a big one. So you run for hours at a time or try to run really fast, essentially beating down the calf muscle fibers and their surrounding fascia and tendons, but then you don’t do anything good for those tissues? Resting is supposed to fix it all? It probably would if you weren’t trying to run most days of the week.

What can you do?

Buy and use a massage stick, foam roller, or lacrosse ball to routinely massage the muscles of the legs. Be sure to emphasize routine soft tissue maintenance for every major muscle group. The technique doesn’t matter as much as just doing something positive regularly for the muscles to keep them more supple and loose. Before the pain rules your life. Once the pain is consistently present, I can use techniques to get it to go away quickly and then you need to take over with a maintenance program.

In many instances, you can think of calf muscle length as an indicator of something besides true structural muscle fiber, fascia, or tendon length. The chronic abuse of running very often leads your nervous system into thinking a higher level of nerve-dependent activity is needed in the calf when it really isn’t. That keeps the fibers holding a greater tension at all times, which makes the calf muscle appear shorter than it really is structurally. So there’s a big difference between your nervous system telling a muscle to behave as if it is tight and a muscle that truly, structurally is short and tight. Weird, I know.

What can you do?

Calf stretching with the runner’s stretch or dropping your heel off a step is typically what runners choose to do if their calves feel tight. But if you want a change in actual muscle structure and length, be prepared for it to take multiple weeks of frequent and prolonged stretching. Like three 60-second stretches at least three days per week. A deep full squat will more likely max out the ankle joint motion and soleus muscle length while a straight leg heel drop on a step is meant to be a gastrocnemius stretch. But I would rather rely on the other soft tissue techniques mentioned above as maintenance, like self-massage, myofascial release, or dry needling to make the muscles relax, which automatically improves their length in many people. Remember, the goal probably doesn’t need to be improving the muscle fiber lengths, it’s convincing your nervous system to let the darn muscle relax.

Running Technique

Certain techniques tend to stress certain tissues more over time - that is neither bad nor good. If there were ever a predictable running method to stress the calf muscles, it would be a forefoot initial contact style, particularly if the runner doesn’t allow the heel to reach the ground after making contact. With about 2.5x to 3x your bodyweight coming through the limb while running, there are huge lengthening or eccentric forces coming through the calf tissue when the forefoot touches the ground before any other part of the foot. This could be the case with midfoot striking too. Depending on the runner’s individual style though, midfoot contact can decrease calf stress. Heel striking itself doesn’t necessarily tend to load the calf the same way a forefoot contact might, but rest assured those people have their own set of problems at the knees, thighs, and hips. Overstriding, which commonly accompanies heel striking, can be more stressful though.

What can you do?

By choosing to use a forefoot contact you should know the calf area is at risk for injury and perform your due diligence with the maintenance just mentioned to keep the calf muscles loose, relaxed, and happy! You may not immediately need to modify your technique to a heel or midfoot strike but could do so temporarily to maintain running fitness until the calf muscle status has been improved. Overstriding needs addressed in any instance. This is where we often need to address hip strength and control, hip flexor length, and other possible issues throughout the entire leg.

Paces, Distances, Training Program Design

What type of running have you been doing lately? Fast, slow, mixed speed, uphill, downhill, shorter distance, longer distance? Are these methods what you have always done or has your training changed recently to incorporate more speedwork, racing, or hills?

What can you do?

If you changed your distance, terrain, or speeds, and the changes contributed to the symptoms, temporarily remove or decrease those stressors for a week or two. Uphills and running faster are the most potent instigators of calf pain. Know the threshold of when the pain would begin while running and then try to stay just beneath that point for a couple weeks while the strengthening and other soft tissue treatment take hold. Be sure to have a full recovery day without sports or running that doesn’t stress the calf muscles.

Footwear

So you thought the zero drop or minimal shoes were great choice? Well, they are, but not if all this other stuff is off and you suddenly change the shoes too. They cause at least a 10% increase in calf load compared to a traditional shoe. Add that onto your already lackluster muscle tissue quality and we have a recipe for trouble. This is also an issue for runners when they switch suddenly from their base training shoes into their racing flats or spikes for competition.

What can you do?

Work your way into minimal or zero drop shoes gradually if you haven’t used them before. Two or three runs per week of 5-10 minutes is plenty in the first month. Run your warm up with them and then switch into your old training shoes. Gradually add faster workouts with spikes and flats into your training instead of just competing in those shoes. Spend more time barefoot at home and be sure to do the maintenance piece mentioned above to get the muscle tone to decrease. Here’s a nice article on transitioning to minimal footwear.

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Recently, I had the opportunity to attend the Healthy Running WV Conference held in Ranson, WV on November 3rd and 4th. There were about 50 attendees from a variety of backgrounds: running coach, MD, PT, DPM, and general runners. I doubt many of them left without having their preconceptions of training, nutrition, or health challenged. And that’s because the two primary presenters, Drs. Mark Cucuzzella and Phil Maffetone, are well known for challenging the status quo. Although both have a long history in exercise performance, lately they are more interested in public health. And for good reason. I wanted to share just a little taste of the information presented.

Attempting to peak for endurance events can be unnecessary, injury causing, and downright unhealthy. Dr. Maffetone suggested that we may really only need 2-4 weeks of speedwork in the final preparation for a competition, and we can perform quite well with no speedwork at all if the aerobic metabolism has been well trained over time. This is quite a bit shorter than the 6-8 weeks recommended by coaches like Arthur Lydiard.

Runners unnecessarily run too fast most of the time. I tell runners this all the time (some believe me, some don’t), but let’s revisit it. Exercise does not have to be uncomfortable to result in health and fitness gains. Dr. Maffetone recounted working with multiple elite and Olympic level athletes that had measurably deficient levels of aerobic fitness who continued to make significant performance gains when he took away their anaerobic training and ultimately trained them at slower speeds.

Food quality is more important to overall health than a specific caloric intake. For everyone, athlete or not, poor quality carbohydrates do an extremely bad job of creating satiety. So guess what? You eat more of them. I’ve hammered my fair share of Oreos and still didn’t feel satisfied. The carbs lead to a dramatic insulin response that can change in magnitude over time. High-quality proteins and fats do a great job of making us feel full sooner and longer after a meal without the dramatic insulin spike. Unprocessed vegetables can even provide a worthy source of carbohydrate. This is not new information to me or many others, but it’s worth repeating for those that are unaware of how prepackaged food, which emphasizes carbs, have made so many things easier to prepare but far less nutritionally valuable.

There are performance and health benefits to emphasizing greater protein and fat macronutrient intake over carbohydrate. Commonly accepted information encourages 60-70% daily carbohydrate intake for endurance athletes. We could get away with 30-40% or even less. Routinely de-emphasizing carbohydrate reliance in training forces the body to rely more on stored fat, which is pretty awesome if you want to run in a marathon or ultramarathon. Then you won’t require as much additional fueling during these longer events, delaying or ultimately preventing the dreaded bonk. Dr. Cucuzzella, who recently maintains a low carb intake, but has run for decades, has the physiology lab data to prove his increase of peak fat burning efficiency from 1.18 grams/minute to 1.9 grams/minute in just a year. These same kinds of beneficial metabolic changes were suspected many years ago by Dr. Tim Noakes in his famous text “Lore of Running.” I’m anxious to see where the research is on this in another 5-10 years.

Sprinting hard at the end of a long event, like a marathon, is more likely to trigger a cardiac event (heart attack) in someone predisposed to having such a cardiac issue. Don’t know if you are at risk? Talk to your physician about finding out your coronary artery calcium score.

A simple glucometer can be an excellent, affordable self-monitoring tool for detecting carbohydrate intolerance and the early onset of insulin resistance that leads to type 2 diabetes. Cucuzzella and Maffetone suggest that people don’t just wake up one day with type 2 diabetes. The changes occur over time because of poor nutritional quality. By the way, a few years back we called type 2 diabetes “adult onset” to differentiate it from the type 1 diabetes that people can have at birth. Unfortunately, that has become a misnomer because young children have begun to acquire type 2 diabetes as the American diet has emphasized low-quality processed carbohydrates since the 1980s.

Insulin resistance is a common factor to a variety of diseases. There is growing evidence that issues such as cardiovascular disease follow long term metabolic changes associated with a high carbohydrate diet. Older research focused on cholesterol but the tide is shifting.

If you are interested in attending a future Healthy Running Conference, check out www.healthyrunning.org for more information.

You can read more about each of this particular conference's primary presenters at the following sites:

Do you ever wonder why some athletes are so consistent in their performance while others are all over the map? If factors like nutrition, training, and physiological capacity are similar between two people, especially at elite levels, there must be a hidden difference or two in why one person consistently outperforms another.

A huge piece of that difference is psychological. One athlete might catastrophize when things don’t go as planned. Prior experience may lead that athlete to experience negative emotions, increased stress, and increased self-doubt. Once a moment of negativity is allowed to creep in, it leads to a steady performance decline. But somehow, another athlete faced with the same issues might continue to excel despite encountering a hiccup. Just how can they do that? Are we born with these skills or is it the result of dedicated practice?

Brain-Body Connection

There is no denying a connection between your psychological state and physiological outcomes. All you need is to feel a little stressed and you can watch your heart rate and blood pressure rise. What if you could reverse engineer this brain-body connection and use it to work for you instead of against you?

Through dedicated practice, focusing consistently on a single task and being aware of that present moment, you encourage control of your emotions and enhance your self-awareness. Perhaps you can decrease the more intense physiological responses that accompany stress. Even though endurance sports, like running, are fatiguing and sometimes uncomfortable, the brain can be diverted to a single focus of operation: to get the primary task done.

I have a theory that the most successful athletes (e.g. happy, consistent) use their sport as a form of meditation. Some have suggested that we naturally seek out altered states of consciousness and exercise is just another gateway to this state. Perhaps this ability to refine and control thought is a key to enjoying exercise instead of dreading it. Sure, there are people that still look at meditation as being a 1970s hippie phenomenon, so they automatically won’t like the idea. But consider it just another skill within a toolbox of physical and mental skills. No psychedelic drugs necessary. By exercising in this semi-meditative state, the brain learns to function and focus in a precise way during that activity.

What is Mindfulness Meditation?

Practitioners of mindfulness meditation emphasize remaining observational and non-reactive to what you might sense during meditation (see footnote below). One result of remaining mindful is improved decision making simply because you have greater knowledge. You then respond to your findings without excess reaction, without judgment. It’s similar to someone telling you, “don’t overthink it.” Who doesn’t want or benefit from improved decision making?

A search of the NCBI database reveals that using mindfulness techniques during exercise is a relatively new research area. Mindfulness concepts are commonly utilized in research on yoga and martial arts. It is also more common to see meditative techniques used in addition to exercise for treatment purposes (e.g., chronic pain, depression, etc.). Mindfulness and meditation are becoming more popular topics, so you can expect more research will begin to pop up.

Using a Body Scan to Control Pain

Endurance sports involve cyclical movements (e.g., steps while running, pedal strokes while cycling, etc.) that provide ongoing feedback from the body. That feedback is useful, if you are listening. You might refer to this listening as a “body scan.” It’s a technique used in mindfulness-based meditation and has been studied for treatment of depression, anxiety, stress, obsessive-compulsive disorder, insomnia, various cancers, chronic diseases, and chronic pain.

Athlete or not, one of the biggest goals of a body scan is to increase your awareness of your body’s signals, top to bottom. During constant activity, the best athletes are able to continuously monitor and adjust their status at any given moment, much as a person would in mindfulness meditation. The athlete is monitoring the important factors as they encounter them, responding with only the absolute necessary changes so that, over time, physical and mental energy are conserved.

While scanning, I frequently discover that I will shrug my shoulders when running harder or becoming fatigued, so I immediately know to drop my shoulders. Or I notice my breathing becomes too rapid and shallow, which reminds me to take a cleansing breath. No surprise, there’s always an immediate improvement in mood, performance, and comfort.

Within an event or training day, one key is to continuously perform the body scan to the point that any small problem is detected and corrected before it becomes a big problem. Maybe some people would consider this a waste of mental energy, and maybe it would be for the unacquainted. Instead, with practice, I would expect it to decrease mental fatigue because it’s far easier to address a small problem intermittently than to become stuck obsessing over a more catastrophic and constant state of stress that causes a flood of negativity.

Other Mindfulness Techniques

Bringing your attention to the present, with something like basic step counting, can push out negative thoughts. You might initially just count four steps before your focus diminishes but with practice it could be 50 steps or 100 steps. Count steps until the next maple tree comes along or the next aid station.

Some athletes are better able to apply meditative techniques if they have a mantra to rely on. Much like step counting, the job of the mantra is to hold your attention. It is a word or phrase that you return to when you find your attention has drifted. It can be something like “long and strong” or “I can, I will.” And still others are able to focus on their breathing count and pattern with great success.

The cyclical nature of an endurance sport also lends itself well to this internal or mindfulness approach because you can become completely lost in the total movement, the breathing pattern, or even the individual footsteps. I’m so stuck in this mode from running that I struggle with counting repetitions while strength training. I become so internally focused on the technique and how the movement feels with each rep (the way I would with running) that I don’t care about the number.

Regardless of your choice, focusing on any of these patterns requires attention to factors other than your fatigue-induced discomfort. They all provide a rhythmic pattern, a consistent place to focus after a distraction, a point of fixation.

Being Stubborn Isn’t Enough

This isn’t simply about being stubborn. Stubborn can get most people only so far. When you finally break at your point of maximal stubbornness, there must be some other tactic to fall back on to hold yourself together mentally.

An experienced ultramarathoner isn’t going to rely on being stubborn through an entire race, though it may appear that way on the surface. They are likely getting to the point that simply feeling their breathing or arm and leg movements can provide a point of focus as the distance gradually ticks away. It’s more about executing at that very moment while turning off emotional and judgmental tendencies.

Application to Training and Competition

In training, try to maintain a body scan or an intrinsic technique focus during short, hard intervals of 30-60 seconds. The goal can be to move quickly and feel discomfort while focusing only on one or two technique trouble areas. You can make the intervals increasingly longer (eg. 5-10 minutes) as you have more success sustaining a focus during the shorter lengths.

Use your miserable days as a primer. Gross weather? Feeling generally crappy? Don’t bail. I hate to spoil this for you but 99.9% of competition days are not going to go as planned. To truly be prepared, you need to experience less than ideal conditions in advance. The rough days are an opportunity to see if you can bring yourself together mentally and maybe even surprise yourself.

Started out a race too hard? Don’t panic. Accept the situation and move on, responding only to your requirements at that very moment. You can’t change the past so stop getting caught up in it. Feeling inefficient? Focus on a component of movement, like arm swing, that you can control. Continuously thinking “this hurts” or “I’m getting slower” is harmful to performance and enjoyment. Once those initial thoughts begin, you will almost certainly begin to slow down and have even more negative thoughts.

You aren’t going to wish an opponent into slowing down and you aren’t going to wish yourself into going faster. Focus on factors that you can control and you just might go faster. But that’s not going to happen without maintaining an internal locus of control - meaning you become solely responsible for and controlling of the outcome.

In longer events, like a marathon, it is wise to not only avoid deep analysis and judgment of your overall condition but to address the basics of what you can at that very moment and reassess after a mile or a few minutes later. Just because you are beginning to feel miserable one minute does not mean you are destined to feel that way 10 minutes later.

According to the book “Running With the Mind of Meditation: Lessons for Training Body and Mind” by Sakyong Mipham Rinpoche: “Ignoring the pain takes enormous mental effort. The first step is to acknowledge the pain. The pain is one thing, and the mind reacting to the pain is another, so the second step is not to overreact. Becoming startled by the pain only exacerbates the pain, like throwing gasoline on a fire: our reaction to the pain makes it even worse. Therefore we acknowledge the pain, but we avoid having the immediate reactionary response.”

Your preferred method of mindfulness may also change with the intensity or duration of exercise. Through most of an endurance competition I’m doing a body scan. Late in a competition I might begin to use a mantra, often rhythmically with the movement. I also like to create a mental picture of how I am moving as a whole, as if I’m watching myself in a mirror.

Find What Works For You

If you have never tried any of these mindfulness techniques before, don’t expect it to be easy and automatic the first time. There is no wrong way to do it; try a few methods and see what sticks.

Some people have the perception that meditating while exercising would require you to completely shut off the outside world. But you have the choice to turn off and to turn on those inputs. If you have to be on high alert for a moment to make sure you don’t miss a turn of the trail in the woods, then stay on high alert. Go back to whatever technique you like once you make the turn. You don’t become a zombie while doing a body scan.

The bonus of these techniques is that you can transfer this behavioral control to other sports and aspects of life like school or work. After developing the mental skills necessary to get through a tough training or competition day, taking that college exam or giving that presentation to your boss might not seem so tough.

It’s worth looking at the various mental skills you can develop while exercising so it isn’t all just a frustrating slog. Certainly, exercise can provide a fantastic time to step away from our stress and problems. And not every moment of exercise needs to be a test of will or focus. Just don’t be afraid to consider the importance of mental skills training if you are seeking performance gains.

Main points:

A body scan, mantras, step counting, and breath counting can all be useful methods to improve performance.

A body scan can be used to continually monitor movement and discomfort levels. It allows you to attend to small running technique flaws or areas of excess muscle tension before they become large and painful problems that will undoubtedly be mentally fatiguing and detract from performance and enjoyment.

Practice the mental focus in training with hard and short efforts initially and then progress to longer and harder efforts.

Bringing your attention to the present, with step counting, breath counting, or a mantra can push out negative thoughts.

Realize no competition is going to proceed 100% as planned. Use your most unpleasant training days as an opportunity for preparing your mental state.

Please share this article with your running friends! To receive updates as each blog comes out, complete the form below. And if you have any questions, please email me at derek@mountainridgept.com.

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1 According to a 2010 article from Birrer and Morgan: “Mindfulness techniques emphasize the non-judging awareness and acceptance of present cognitive, affective and sensory experiences, including external stimuli and internal processes. Stimuli that enter awareness are observed but not judged, and internal experiences (thoughts, feelings and sensations occurring through internal or external stimulation) are instead accepted as natural, transient facets of human existence.”

1. Don’t assume you should stop running entirely. There’s a good chance you will make the situation worse by fully stopping. One or two days off is reasonable. Your body’s tissues maintain themselves best when there is a baseline frequency of exercise. Take that particular baseline away for several days and those tissues have no reason to maintain their adaptations to exercise, so they will actually weaken and regress. Tendons, muscles, ligaments, it doesn’t matter. All of these tissues begin to degrade without regular use. It’s the same reason astronauts become weak and lose muscle mass when they travel to space. The frequent demands of gravity here on earth are suddenly gone so their body says “if you aren’t going to use this *fill in tissue name here* anymore, then I’m going to start to break it down - it’s a waste of energy to maintain it for nothing.” You don’t want to lose more of these hard-earned adaptations than you have to.

2. Don’t be afraid to deviate from your previous running pace and distances in order to stay active. If there is one thing that happens very commonly after an injury takes hold, it’s that folks assume resting fixed their problem entirely when the pain *appears* to go away. So what if you took two days off? Expecting to jump back in at the same level of pace and distance is often disastrous. Just as I mentioned above, the tissues maintain a certain level of adaptation. By jumping back in at the previous intensities and distances you may actually be stressing the tissue at a rate greater than it can adapt. Remember, this was injured tissue that caused pain just a couple days earlier, which probably means it wasn’t adapting quickly enough to begin with. It is unlikely that magically, with a short little rest, that the area suddenly became “normal” uninjured tissue again and you can start beating it down with your typical training. Temporarily decreasing the intensity and distance to decrease (but not eliminate) the overall demand on the tissue is often a better solution for overuse injuries. It typically takes weeks and months for an injured area to remodel and you can certainly progress again during this time if the running is dosed appropriately.

3. If you have a competition coming up and it’s something like one to two weeks away, there’s a good chance you can still compete and do so at the level you had hoped - if you play your cards right and don’t panic. How much measurable fitness do you really think you were going to gain from that one last long run? This is more of a psychological barrier than a physical one. If you had been training consistently for two or three months, or years for that matter, then you have the necessary fitness. Yes, it’s frustrating and a blow to the ego. Nothing ever goes as planned anyway, does it? It’s usually not worth testing things to their limits when you can easily increase or maintain fitness with things like cross training.

4. Cross train, but do it right. Yes, I understand that no other form of exercise seems to cause the same type of wonderful fatigue and satisfaction that running does. Which, again, is why people try to push the distances and paces prematurely. But if you need to cross train, doing hard interval or tempo work everyday on the bike or elliptical isn’t the right way to go. I would hope you wouldn’t do that running (although I know people who do). The same principles apply to cross training as they do to running:

super easy recovery to stay warmed up and loose after harder days

aerobic work for aerobic fitness

intervals and tempo work for improving anaerobic fitness

maximal efforts for improving that nerve/muscle connection and gaining more anaerobic fitness

I am absolutely convinced that a semi-experienced runner can cross train for several weeks, never run, and still achieve their goals if they do it correctly.

5. Don’t forget about this current injury when the next injury comes along. More often than not, these injuries will be connected to one another. Every week I see people who had a low back injury that eventually played into a hip problem that became a calf problem which morphed into a foot problem. Our body’s are so good at compensating for pain, loss of motion, and weakness that we can nearly always get the job done - for a little while. The trickle-down and displacement of forces doesn’t bode well in the long run. Fixing problems correctly the first time around will play out better.

6. Some medicines are actually inhibitory to normal healing processes if taken for prolonged periods. This is partly due to the fact that inflammation is a desirable and necessary part of healing. It is just that inflammation is accompanied by pain and we all want to get rid of that part of the equation. Taking drugs to modify the inflammatory response over a longer period of time (>2 weeks) may result in an incomplete cycle of healing. Here’s one recent review (https://www.ncbi.nlm.nih.gov/pubmed/22744434). These drugs are also an important factor to consider in bone healing from issues like stress fractures, as reviewed here: http://bjsm.bmj.com/content/39/2/65.

7. Prevention is the best medicine. Remember, you can have too much of a good thing. Exercise and running are good only up to a certain point and that point is different for each of us. Maybe if you had just taken a full day off every week for the past month, then perhaps this injury wouldn’t have happened. You will do best by emphasizing proper recovery time, doing regular soft tissue maintenance, refining your running technique, attending to nutrition, and being consistent with slow progressions in training. If I had a dollar for every time I’ve heard “well, I felt good so I decided to go an extra four miles” from people that aren’t feeling so good right about the time I see them in the clinic. There is always a breaking point and you can find it by throwing caution to the wind. (Not saying I haven’t done these things myself!)

8. Don’t “test” an injured tissue repetitively and expect a different result. Here’s a common scenario: Monday I tried to run and my leg hurt within 200 yards, so I stopped, figured I would just rest a day. Tuesday I tried to run again (because Monday was a failure) and the pain started again at around 150 yards. Ugghh, I hate being hurt. Wednesday I’m really aggravated and surely the last two days of “rest” have fixed it so I run for 300 yards, even though pain started at around 200 yards again, before I reluctantly quit because of the pain. Thursday I’m really angry and try to run again. Friday again... Notice a theme here? Numerous days of testing the injury, pushing until and through pain, ultimately delays improvement. It’s clearly not going away. The right thing to do is seek help from an injury treating professional, not a personal trainer and not a coach unless they are going to refer you to a valid licensed professional. It is important to consider what pain intensity we are referring to. If it’s enough to make you consider quitting the run, that’s probably a good sign that you should indeed stop. Nor would it be good to push through pain that makes you change your technique for pain avoidance. If the pain is occurring early in the run and worsens rapidly, you aren’t going to win the fight. Every time you test an injury like this, it’s just inflaming the tissue all over again after it has tried to calm down.

Please share this article with your running friends! To receive updates as each blog comes out, complete the form below. And if you have any questions, please email me at derek@mountainridgept.com.

In the last article we reviewed suggestions to analyze past workout data. Now for an overview of preseason planning.

Establish training and competition baselines for comparison.

Maybe very recent or older, like a couple years ago, as long as you have the old data for support.

Considerations include baseline times for a specific distance, maximum distance, highest average power values, best pacing execution, or just about any factor you would like to see improve.

Find the events you would like to attend.

Seek out something new. You never know when you might find an event that you like more than your usual races.

Analyze the specific demands of your planned events.

Course layout

Distance

Elevation gradients and totals

Average temperature and typical weather

Set primary performance goals. Don’t be afraid to set lofty goals as long as they are achievable. These can vary drastically, likely being the most specific for an experienced athlete. For example, it could range from:

“I would like to finish a marathon.”

“I would like to finish the San Francisco Rock ‘N Roll Half-Marathon with a time of 1:40:00.”

“I want to run the Boston Marathon in 3:15:00 with the pace never dropping below 7:30 minute/mile or going faster than 7:00 at any time.”

Set midpoint performance goals to determine if progress is being made. For example:

Perform a weekly total activity duration of 8 hours and a single longest effort of 2 hours after 8 weeks of training.

Perform 7:00 minute/mile pace for 8 miles in a threshold/tempo workout.

Achieve a single day of long distance of 17 miles after 8 weeks of training.

Set the component or technique goals that must be met to achieve the primary and midpoint performance goals. Without executing these component steps, you can’t expect to reach the performance goals. For example (these values are theoretical):

Consume and tolerate 12 ounces of fluid per hour while at race pace.

Consume and tolerate 200 calories per hour while at race pace.

Maintain an average of >170 foot strikes per minute for at least 2 hours.

Maintain a run power between 200-250 watts for at least 2 hours.

Go slower to get faster.

I’m a fan of higher volumes of low intensity work with only occasional high intensity work. It’s probably not an accident that professional athletes in any sport lasting for long durations have adopted this strategy. You can’t train hard every day. This is especially the case with older athletes because they just don’t recover as fast as their younger counterparts.

As you get closer to an “A” event, emphasize increasing the higher intensity work while decreasing overall duration and distance.

If you are planning to do a lot of competing to “race into shape,” you must come to terms with the fact that not every event can be a PR event.

You will need to give up some hard workouts to do the competitions instead. Define which events are the real priority and just let the others go as hard training days.

Allowing a longer build period is generally a safer option because it allows for greater physiological and more gradual structural changes.

Our connective tissues adapt much slower than our fitness. That’s why we often end up with physical injuries instead of metabolic problems.

Shorter races require less progression time.

Longer races require greater progression time.

Plan for strength training.

This overlaps with performing those exercises that the evil PT gave you. I doubt every muscle in your body is at its optimal strength level.

Plan for other cross training.

Your cardiovascular system doesn’t know what activity you are doing. Your tendons, muscles, and nervous system need to adapt and learn the pattern and load of running to be efficient and prevent injury but performing other types of exercise, like swimming and rowing, will not detract from those abilities.

Involve your friends and family.

Where would your family like to go for a trip or vacation?

What events are your friends doing? This might get you a new training partner, which is great if you are occasionally struggling to leave the house in the winter. But it might backfire if you are the one always providing the real motivation.

Consider other equipment to more objectively measure performance.

I get the idea of simplification. Maybe you can and should get by with a basic watch if that has always worked for you. But if you get injured often or can’t seem to break through plateaus, then the extra data from a power meter, GPS watch, or phone app isn’t going to be harmful and may actually help you see where the mistakes are happening. You can always collect the data without looking at it immediately, and analyze it later.

If you have an injury that keeps recurring, get professional assistance to take care of it in the off-season, not a week before your “A” race.

Most injuries should be objectively improving within a month when properly treated. If they aren’t, there better be a darn good explanation or else I would find another professional to look things over.

Don’t expect miracles though. Sure, I can often provide somebody help (a.k.a. less pain) in just a couple visits but that doesn’t mean the problem is gone. You have to be reasonable with the rate of improvement and do your homework regularly.

Plan for rest and recovery. If you don’t plan it, you won’t take it.

Plan for periods of recovery from individual workouts within each week, from blocks of workouts over a series of weeks, and after the entire training cycle that brought you to a big competition.

Whatcha’ gonna do with all that data? Use it to plan next season, of course.

We log workout data, and some of it never sees the light of day again. Whether you like the old school pencil and paper method or the website technology of Strava, Garmin Connect, Mapmyrun, or others, it’s worth reviewing from time to time. I favor the digital side. Mostly because it makes the math easier and I can make some pretty sweet maps and graphs afterward. There are few things I appreciate more than maps and graphs.

My 2016 running heat map

So why are you really tracking all of this information? Most would say to allow the ability to see when they are improving. Bingo. But there are a few more reasons to keep track of and analyze the information regularly.

Increase the chances of short term and long term success

Compare real objective measures to what you *think* is going on

Improve your time management

Determine where injury or overtraining may have occurred (a breaking point)

Determine whether you met your full true physiological potential (or if you were just slacking off)

Make it easier for a coach to analyze (currently or on down the road)

Remind yourself of events and workouts you never want to do again

Remind yourself of events and workouts you would love to do again

Determine overall strengths and weaknesses

Prevent burnout

Define reasonable future goals

Recognize any past goals met

Discover what aspects of training and competing are really important to you

I started keeping a training log when I was around 15 years old.. Too bad they didn’t have these new-fangled wrist-worn GPS devices back then. There was more guesswork at distances and paces, especially because I was just making courses up. And sometime in college I tried logging everything into a Microsoft Excel spreadsheet, but that felt too cumbersome. Somehow, there are people still doing this! I salute your ability to tolerate the pain delivered from the software equivalent of a Ford Model T.

A spreadsheet isn’t specialized in its design, but it has the potential to be more informative than a paper logbook. Now the GPS watch companies produce some pretty decent metrics and there is additional software like Golden Cheetah and websites like Training Peaks that gobble up and produce more information than anyone can ever want or use. I love it.

At the least, take a look back at these basic measures:

Total yearly time

Total yearly distance

Average daily, weekly, monthly, yearly mileage

Average daily, weekly, monthly, yearly pace/speed

Competitive performance times, distances, paces

If there is one thing I can emphasize, it is that you should pay attention to trends, not single workouts, weeks, or even single months. Success is not built upon these brief intervals of time, nor is failure. Most injuries are not the result of what happens in a short period of time either.

Monitor the trends of speed, mileage, and duration for each week, month, and year. Following these trends, you can determine if there is consistent improvement or recognize unexpected losses before it is obvious in your performance.

Average speed across 2016. Trend line peak coincides with June event where I wanted a best performance.

Solely considering mileage, sure, you can progress each week greater than the generally recommended 10%, but should you do it for several weeks in a row? Most people are not going to withstand those increases. If you don’t look at the long-term trends, then you may just very well forget that you progressed 30% in volume for two weeks in a row just a month ago.

The same would apply to the quantity of high intensity work. Progressing too rapidly in the volume of intense exercise can be a problem, even if total amount of time or distance stayed the same from one week to another. Progressing too rapidly will eventually cause a problem one way or another.

Were you injured this year? Compare the time frame where you were injured to the time frame just prior to injury. Was there a fluctuation in intensity or in mileage volume? Maybe it’s something you can’t quite put your finger on.

That’s when you realize that miles, pace, and distance do not tell a full story. This is where more advanced measures become helpful. These advanced measures are likely to be most beneficial to an athlete that is trying to make a large amount of progress or achieve their peak fitness:

Fatigue points

In terms of time, where did you begin to bonk or have a drop of pacing? Where did you think “this stinks” or begin to mentally struggle with the work being done?

These points are commonly where technique breaks down. It’s good to have a specific goal for when these moments arrive. For instance, if you know your cadence starts to slow, let’s say to 165, then focus entirely on keeping it higher, like 175.

Mimic these moments in training in order to determine the resolution that allows you to avoid injury and performance decline. You will probably never fully avoid these points but with training you can keep shifting them further away to prolong the time before trouble strikes. Of course, this is dependent on other factors that would need to be duplicated, like speed and distance. With that in mind, this clearly isn’t something you would try to work on everyday.

Acute:Chronic Workload Ratio

Calculated as the most recent weekly mileage or duration divided by weekly mileage or duration total during the last 4-8 weeks. This is a newer consideration, yet so simple. It was introduced in the 2015 research with a study on rugby players. They found that having a high ratio of 1.5 or greater was a associated with onset of injury. Interestingly enough, a ratio of 0.85 to 1.35 was found to be protective to injury acquisition. Even though the research was done on rugby players, it’s easy to calculate, so I would suggest applying it to your training if you can measure volume. The result is similar to a 10% weekly progression.

Pressing my luck with an acute:chronic workload ratio of 1.7 for a little while there.

Average daily, weekly, monthly, yearly heart rate

Yes, I know heart rate isn’t the most fabulous measure. But if you are using only the basic metrics, this is a good place to start because devices are now measuring heart rate at the wrist and the chest straps are way more comfortable now than 5 years ago. Trends in heart rate can demonstrate overtraining habits or improvements in performance. For instance, if I am ramping up my base miles I can compare performance on a certain loop at the same pace/time and might see a lower average heart rate for the same speed.

Average heart rate was at its lowest while heading into June as well.

Elevation gain/loss

Someone unfamiliar with the impact of elevation might mistakenly call an average pace of 10 minutes/mile “slow.” They aren’t accounting for the fact that the average mile climbed was 200 feet. This is the main reason I do not believe in online running pace calculators for training or competing on hilly terrain. This is why power will be a much better measure of effort and stress. So...

Power

A newcomer to the running world. Just give it a couple years and many of you will have power data on your fancy GPS watches.

Although the current power meters for running don’t directly measure the force produced by your body, it’s still more accurate than guessing based upon how you feel.

With software like Golden Cheetah or Training Peaks, you could dive even deeper with these calculated measures:

Critical velocity

Critical velocity is the pace that you could theoretically sustain for an indefinite amount of time. Training at or above critical velocity is one way to focus on becoming faster.

Training stress scores

Training stress is a measure calculated by considering heart rate (as a measure of intensity) and time.

Acute or short-term training stress (stress over the last 7 days) vs.

Chronic or long-term training stress (stress over the past 42 days)

Training stress balance is about managing the balance between the two in order to provoke higher competitive performances

Training stress graph for 2016

Next post I'll go over more planning tips. Please let me know if you have any questions at derek@mountainridgept.com.

Have you ever wanted to improve at something? Shooting a basketball, playing a guitar, public speaking - the task doesn’t necessarily matter. If you’ve ever thought “I could do this better than I am right now,” then you clearly wanted to improve. But did you actually take the steps necessary to create that improvement?

The problem is that there is a lot that goes into any improvement: seeking guidance, planning, good old-fashioned work, patience, practice, discomfort, commitment, nasty emotions, vulnerability. Improvement arrives only with overcoming these obstacles.

By trying to become better at anything, you open yourself up to the judgment of others and to self-ridicule. After all, we are often our own worst enemy.

I understand that for patients to seek treatment for an injury they are sticking themselves out there, making themselves vulnerable to some stranger’s judgment. But once that ball is rolling, it’s unusual to see someone regret the momentum.

Fear of failure is undoubtedly most of the reason we fear vulnerability. And there are also those who have a fear of success. Perhaps it’s just fear of change. Change leads to other obstacles, more demand, and the cycle never stops.

In any circumstance, it’s easier to maintain the status quo. You are less likely to attract attention or to be exposed to your peers. Maintain at all costs, we think, simply because it’s comfortable.

Improvements in performance (and often in life) are made when you venture outside the zone where you are comfortable. Without the discomfort of the unknown, there is no learning, nothing gained, probably no real experience you will recall at a later time when faced with challenge.

It can be oddly addictive to enter the unknown provided that some good experience comes of it. If you succeed, the psychological reward is substantial and probably reinforcing enough to have you sustain your behavior.

Of course, if you fail (whatever that means) then your attempt to go beyond your perceived limitation is punished. Maybe that has already happened with enough potency or frequency that you don’t seek the unknown any longer.

I suppose this risk versus reward balance is why some people jump out of airplanes. Now that’s definitely a place of vulnerability. A significant adrenaline rush counteracted by the potential for an ultimate failure.

But I’m not asking anyone to jump out of an airplane. I’m suggesting that if you want to truly improve at a task that you must venture into it without thinking too much about the concept of failing.

Because, really, what is the result if you “fail”? Nobody dies. The consequences are rarely as inflated as we make them out to be. You could take comfort in knowing that you can often return to the status quo. Or should you?

There is a difference between feeling vulnerable and truly being vulnerable. Failing makes people feel vulnerable but really it is just a step in a process to making gains. Left unchecked, emotion won’t lead to development, but that is what most of us use to make our decisions. It’s perfectly okay to feel vulnerable but letting it be a barrier to forward progress is where most people succumb, so they never realize improvements.

Success is a potent ingredient in the formula to overcoming any fear and vulnerability. Really you are the one providing your personal definition of success. Perfection does not exist, therefore success cannot be perfection. Success is a belief that you can achieve something greater. The reality is no one else is analyzing the daily minutiae of your life. If they are then they must be really bored, or perhaps jealous.

You don’t ever know exactly what is going to happen, even by taking the comfortable solutions and sticking to the norm. Why not try something different? Make yourself vulnerable.

Prediction of running performance is nothing short of an intriguing concept. Everybody wants to know what they are capable of achieving, according to internet math, even if they don’t actually pull it off in real life. Predictive measures have been used to obtain expected race times for multiple decades, and I would like to think they are more accurate now than in the 1970s. There is nothing like a true performance at a specific distance to guide your training and racing. But for a beginner or someone that has done just a handful of events, a race predictor can be really helpful to determine appropriate pacing.

I recently came across an article on a new marathon time prediction method that can be found here. The calculator is found here. It is based on research by the same author, available at this page. The researchers used my favorite statistical method, regression analysis, to create a prediction model for amateur runners, based on amateur data. This differs from previous predictors which were largely created from the performances of elite runners.

Runner’s World recently updated their predictor to this same format because it tends to generate a slower time than other predictions would develop. Why is that important? To keep you from blowing up badly, particularly if you are mid-pack or slower runner.

The nice thing about this specific calculator is the fact that it considers your average weekly mileage in the equation. This lets you see where training can play a role. You can really ask yourself if that extra 10 miles per week is worth it when the gain is just one minute over the course of an entire marathon.

For some, of course, the answer is “yes.” But for others that extra 10 miles each week can result in frustrating injuries that could keep them from training and racing altogether. And maybe during that 10 miles you would rather be playing with one of your kids. There is also research to indicate a lessening health benefit of higher mileages (http://www.mayoclinicproceedings.org/article/S0025-6196(16)00068-9/fulltext). The predictor provides a nice method to weigh the diminishing levels of improved performance with the benefits of health and sanity.

This had me thinking, it would be interesting to see how training type plays a role in the goal performance for a given individual. In other words, do you gain more improvement from a focus on long, base runs, or on high-intensity interval work? The average marathon training program is going to include both, because they work different metabolic systems, but I would be curious to know which is more critical for a given person. Sometimes it is obvious, sometimes not.

Let’s say you want to run a 3:30 marathon on 25 miles per week but the predictor expects you to do a 3:35. Is there a certain type, frequency, or amount of anaerobic training that could make up the difference while keeping the mileage that low? Maybe that’s not reasonable and it really comes down to making sure you get in increased mileage to gain that five minutes.

It will undoubtedly vary depending on training history and genetics. The Crossfit nation would try to make us believe that it’s all about the interval training. I would argue that lack of familiarity with longer distances weighs more heavily in a new runner than any amount of anaerobic ability gained with high-intensity intervals. Once you have some base training and long racing experience, then feel free to focus on both or just on harder intervals. I venture a guess that intervals and tempo efforts gain fitness for many people simply because they haven’t stressed themselves in that specific manner. That fitness won’t help much if you mentally crack at mile 23 because it’s all new territory.

To think you can do a marathon well and only do long runs of six or eight miles seems like a recipe for disaster in the uninitiated, though. For a 5K or 10K race, I suspect that many amateurs could rely heavily on interval training two to three times each week for multiple weeks in a row and never once do continual easy or moderate paced runs. Yes, it would still be useful to at least occasionally cycle through weeks of longer, slower base training to stress the aerobic physiology. It is not common to fluctuate training this dramatically, though. Yeah, the mileages would be all over the place. I may have to use myself as a test subject. Maybe it’s a little different way to consider “polarized training.” If nothing else, it is a definite change of pace.

The variation of training stimulus could keep injury rates lower yet continue to change fitness. I recall reading a research article many years ago indicating performance gains in elite level endurance athletes because they essentially doubled their base aerobic training time. These are athletes that are already at the top of their game but they swung the training pendulum one direction and changed their program so dramatically that it helped get them through a plateau. This can clearly work both directions.

My only concern is to be cautious of injuries. Hyper-volume training is surely a recipe for overuse injuries. Too much interval work could be a problem too, especially if you were trying to keep overall weekly mileage high, if your interval running technique was drastically different than your normal slow technique, or if your muscles and tendons were just not up to either task because of strength deficits (a.k.a. start strength training in any case).

The main reasons to wear compression garments, like compression socks, would be to: 1) improve athletic performance or 2) improve recovery. Is compression wear worth the hype in either of these cases?

Performance:

A 2016 review on the effects of multiple types of compression garments (Engel et al.) examined 32 studies performed between 1987 and 2015. In eight of the studies they found no significant improvement in race completion time with compression for any distance from 400 meters to marathon. In seven studies, they did find a small improvement in time to exhaustion while wearing compression. Four studies reported improved running economy values. Sixteen of the studies were associated with improvements in psychological variables.

Despite being financially supported by a garment manufacturer, a 2015 study by Areces et al. found no benefit of compression socks in post-marathon exercise performance or race times.

In a 2015 literature review of four studies by Stanek, compression socks were reported to have no effect on several physiological measures like heart rate, perceived exertion, and lactate levels. Although one of the four studies noted an improvement in maximal running speed.

Recovery:

Performance improvements are often based on perception of effectiveness. In a 2016 study by Brophy-Williams et al. the participants were asked about their perceptions on the usefulness of compression socks in enhancing exercise recovery. This article is ahead of print, but according to the abstract (yes, I know that’s bad science) the participants performed better if they believed the compression was going to be helpful in recovery. Thank you placebo effect.

The 2016 Engel review of 32 studies found nine articles reporting large positive changes in exercise or post-exercise muscle soreness.

A 2013 meta-analysis by Hill et al. revealed some benefit in reducing the pain of delayed onset muscle soreness. They also found that muscle strength and muscle power measures recovered more quickly with compression usage.

A 2016 meta-analysis by Marqués-Jiménez et al. identified several studies indicating multiple biochemical markers were improved following exercise if compression garments were worn. In five studies, muscle swelling was also improved. Another eight studies indicated improvements in exercise recovery in muscle strength and five studies in muscle power.

Anecdotally, I don’t find compression to change anything about my personal running performance. Maybe I would notice a change if I used it more often. But I definitely do like the way compression feels for a day or so after a hard workout or race. I really love the way compression feels at super high levels with a compressive device - above 80 mm Hg, which isn’t what these studies and reviews analyzed. Even if compression garments aren’t changing recovery on a physiological level, they are all capable of decreasing the sensation of soreness.

It appears that the most recent research evidence supports the use of compression in decreasing the intensity of delayed onset muscle soreness. The helpfulness of these garments may be event greater in an individual that must spend more time on their legs during the post-exercise period of soreness. Let’s say in a multi-day event or going back to work on Monday.

Could you make arguments for using compression using the latest literature? Sure. Would I use it in every race or workout? Nope. The reality is that if you think it helps you, then keep using it.

The scene: It’s a hot, 75 degree Saturday in June, humidity 85%, birds singing. Maybe the most hot and humid day so far this month.

The athlete: Is 6 miles into what is expected to be a 15-mile long run. Last night they enjoyed a couple beers with dinner after completing a 4-mile easy run. Work was pretty hectic, so they drank coffee all day to keep focused. They didn’t consume much water or other fluids.

The cramp: Comes quickly into one calf during the long run, rendering the leg nearly useless and painful, despite the individual believing they weren’t putting out much effort. This has happened before. The runner stretches the muscle for 10 seconds, decreasing the pain and begins to run again. Four minutes later it happens again so they repeat the process until 8 miles, when they finally quit the run out of frustration.

Talk about a wasted training day. Did this runner do something wrong in their preparation for this run? Yes. No. Maybe. Perhaps I’m trying to trick you a little because the truth is we don’t have enough information about the entire situation. What is their maintenance routine like outside of running? Do they strength train? Have they eaten during the initial part of the run?

SO MUCH TO THINK ABOUT

You should see that there are a variety of factors to consider regarding the onset of muscle cramps. Here are some you’ve heard of and maybe some you haven’t:

Prior training experience regarding intensities and durations

History of muscle cramping

Current hydration status, particularly related to level of sweat loss

Electrolyte levels of magnesium, calcium, sodium, and potassium in the blood and muscles

Muscle tone, which is controlled by the nervous system and reinforced by day-to-day use patterns (and also changed with routine soft-tissue maintenance)

Stimulant intake, such as caffeine, which impacts nervous system function

Recent physical activity and fatigue levels

Environmental conditions regarding temperature, humidity, and terrain

Muscular demands at that moment, as in the force of muscle contraction required

Direct muscle trauma

There is likely an interplay of these factors and you therefore need to consider them all in muscle cramp prevention. How are you going to do that? Partly with good regular maintenance and training habits. Partly with a little trial-and-error testing.

Muscle cramps have been a thorn in the side of many athletes for decades, and what fixes them in one athlete may not work for another. Some athletes just seem more prone to cramping while others have minimal issues. I would be surprised if the crowd that is prone to cramping didn’t have at least one or two of these areas to address though.

Available research indicates three main theories exist in the cause of exercise-induced muscle cramping:

“Extensive sweating and a consequent significant whole-body exchangeable sodium deficit can lead to more widespread muscle cramping, even when there is minimal or no muscle overload and fatigue.” (Bergeron, 2008)

“Either neural activity in the spinal cord or in the peripheral could be the cause of the cramps.” (Nakagawa, 2013)

WHAT WE'VE GOT HERE IS A FAILURE TO COMMUNICATE

Lately, the neurological cause has been winning research arguments, so it would make sense to try the solutions that have the most bearing in that area. I frequently tell athletes that the muscles only know what they are told by the nervous system. Without a motor nerve supply, muscles are useless masses of floppy meat. Which means that if the communication between the motor nerves and the muscles goes wrong, you will have a failure of the muscle’s normal function.

This nerve-muscle communication is as much about sending signals to a muscle as much as it is about stopping those signals. It is possible that, with repetitive use and fatigue, the signal from the motor nerve to the muscle isn’t stopped as efficiently as it should be and then the muscle insists on maintaining a contracted state, otherwise known as a cramp.

If cramps occur intermittently for you during exercise, the most likely scenario is one or a combination of these factors:

Poor self-maintenance habits of the muscles

Poor nutritional choices

Subpar preparation of the muscles and nervous system for the task at hand

Neglecting to account for environmental demands

YOUR HOMEWORK

Prevent the cramp with proper preparation and regular maintenance:

First and foremost, if you always cramp in the same muscles, I would not be surprised to find that the resting tension in that muscle was elevated compared to muscles where you don’t ever cramp. Cramping muscles are likely to be more tender to firm pressure. Plus, you may be able to tell that those muscles are physically more taut than your other muscles. Your focus needs to be on getting that resting activity to decrease at all times. For that, you are going to routinely and specifically massage that muscle 1-2 minutes every other day with a massage stick, lacrosse ball, or your hands. It should be uncomfortable to work on the irritable tissue. And it’s going to take a month or two of consistent work to keep that muscle more relaxed. If you want it quicker, then my suggestion is to have dry needling to “reset” the nerve-muscle communication.

Strength train the muscles that routinely cramp to increase their fatigue resistance while simultaneously strengthening any other muscles that can assist with the same motion. For example, the calf muscles are effective pushing muscles so be sure to address any strength loss in the other rearward pushing muscles like the gluteus maximus and hamstrings.

Consider the psychological aspect. Cramping has a lot to do with nervous system function. You aren’t going to make the situation any better by increasing anxiety and stress levels. Athletes that struggle with this need to practice techniques that can lower their stress through deep breathing, meditation, yoga, or sports psychology. It’s no surprise that you could train for weeks without cramps but on race day the anxiety increases at your main event, contributing to the mystery cramps.

If you are expecting to be in a competition that requires minimal or significant terrain changes then try to duplicate those changes or lack of changes in your training.

Progress gradually and consistently in durations and intensities of prolonged exercise.

It’s easy to suggest staying hydrated. Typical advice. Just keep your urine on the clearer side consistently. Not just the day of or day before longer exercise bouts. Don’t overhydrate because that can carry health consequences as well.

Consistently eat a well-rounded diet. If you start restricting specific foods that carry important nutrients, then you need to ensure you are obtaining a suitable replacement. For instance, by restricting meat you may cut out a large magnesium source. Do your research on what micronutrient requirements frequent exercisers have and adjust accordingly.

Prevent the cramp during activity:

Vary the range of motion and demand on the muscle as much as you can before you have any sense of cramping. For instance, to change the motion and demands of the calf while running switch from your usual forefoot strike to a heel strike for 20-30 seconds every 1-2 miles. Research indicates that the muscle fibers must achieve a shortened state in order to cramp (Bertolasi, 1993). For instance, if you are constantly running on your forefoot, the calf muscle fibers don’t get a chance to elongate, keeping them in a shorter, and riskier, position at all times.

Eat something containing carbohydrates during the exercise. It stands to reason that if muscle fatigue is delayed by eating to supplement energy stores, then you may not cramp as soon or maybe even at all if a few calories are always coming in (Jung, 2005). Nerves must have a supply of energy to function, too. They like glucose. It never ceases to amaze me how many people think they can go harder and faster in an event than they do in training with fewer or worse yet, no calories. Multiple systems change function without normal blood sugar levels.

Stick to a reasonable plan. Just because you feel good physically and mentally from resting a couple extra days prior to competition doesn’t mean you should suddenly decide to pursue higher intensities than you have trained for. Even if you don’t cramp, you will probably bonk in a long event, or blow up in a short event.

If the cramp happens:

Attempt to stretch the muscle. Do not stretch it rapidly and do not stretch it as hard as you can. A gentle but prolonged stretch is the best option at this point. Hold the stretch for at least 30 seconds. Now is not the time to bounce to the end point of the stretch because you have special structures in place to cause muscle contraction when that bounce hits its end point.

Massage the muscle with firm pressure. Even a single, prolonged pressure of 30-60 seconds to the muscle may break its cycle of cramping.

Eat. Didn’t I just go over this?

Try my personal favorite solution, dill pickle juice, as the muscle threatens to cramp. It’s not the salt that is effective but the noxious stimuli from the vinegar. A new sports drink named Hot Shot relies on a similar mechanism but it has more of a spicy flavor. Either way, the potent oral stimulation effects nervous system input.

Try a couple electrolyte tablets or maybe a sports drink containing electrolytes. This isn’t supported by research, but a placebo effect is still a possible effect. But will you still have the placebo effect now that I’ve told you it shouldn’t work? Please let me know how that goes. I personally stopped using them.

Overall, you must adjust according to the variety of factors at hand. If you know you are under-hydrated, aren’t eating enough, haven’t maintained your frequently cramping muscles, undertrained, stressed out, and it’s really humid outside, then your best option is to slow down a little, learn a lesson, and work on the flaws before your next event.

There are instances where cramping with great frequency can be a sign of diseases and serious neurological issues so do not hesitate to contact a medical professional if muscle cramping is occurring outside the realm of exercise. Even a history of sciatic nerve problems can predispose a person to cramping during exercise.

Take care of the muscles and the nervous system with planning and preparation and they will take care of you.

Please let me know if you have any questions at derek@mountainridgept.com. And definitely let me know if you find some of these ideas helpful in muscle cramp management by liking the Mountain Ridge Physical Therapy Facebook page. Or buy me some dill pickles.

Here are a few more tips to consider when looking for your next pair of athletic or running shoes.

Always take a potential new shoe for a several-minute test run. You wouldn’t marry someone without dating, would you? Walking mechanics are not running mechanics. Jogging in place doesn’t count. Use the shoe like you plan to use it.

Try to fit your new shoes at the end of the day to account for swelling. It’s even better if you have already gone for a run. Just find some clean socks first.

Feel around the inside of the shoe for areas of prominent stitching or materials that could become blister-producing sites.

Check for manufacturing flaws. The shoes should be symmetric in construction of their uppers and soles.

A wide and appropriately tall toe box can be a lifesaver. Everyone thinks of the foot as having a single arch but we actually have three arches. One of those arches runs through the forefoot at the ends of the metatarsal bones. Scrunch those metatarsals together in a narrow shoe and that arch doesn’t function appropriately for stability, shock absorption, or propulsion. You also run the risk of compressing the nerves that are between the metatarsals.

There hasn’t been any convincing research to indicate that the various types of shoes (cushioning, stability, motion control) can decrease injury risk. Which is why you need to emphasize finding a shoe that feels good more than any other goal.

Realize that shoes are not an appropriate fix for lost motion of the ankle and big toe. If you keep acquiring the same injuries regardless of shoe choice, the problem isn’t the shoes. You need to have a trained expert in movement analyze your strength and motion. Let’s say your lower leg muscle group has shortened over a series of years and you switched to a zero drop shoe because it was trendy. That might be a little dangerous if you don’t allow for a several-month-long adaptation period. It would be safer to transition from a shoe with a thicker heel height to less heel height and then to zero drop.

The heel cup should not allow the heel to slide side to side or up and down once the shoe is laced snugly.

Don’t forget about the footwear you use during the rest of the day. Your body will adapt to the positions it stays in the most. Which means using a thick heeled shoe during the day only to switch to a zero drop shoe for a 45-minute workout is a sudden and severe change.

Use multiple types of shoes in training. This helps vary the demands placed on your body and may even help prevent overuse injuries that come from repeatedly working in the same range of motion.

More cushioning is not always better. Shoe manufacturers love creating trends because trends equal money. Now that we have passed the minimalism trend, it’s onward to maximalism. Here’s the thing with those super cushiony shoes: more cushioning means you will hit the ground harder. Our bodies are always trying to seek a sense of stability and in order to obtain it, your foot will try to plow right through a thicker layer of foam. And the more foam, the lazier your gait can become. Muscles, tendons, and proper technique should provide most of the impact absorption.

Have you felt the stress that arises when a shoe company stops making your favorite shoe? Like car manufacturers, shoe companies have a tendency to constantly tweak things, even when they don’t need to be tweaked. In an effort to look a little cooler, or supposedly function better, shoe construction is altered from one year to the next, forcing you to chase an ever-changing ideal. Here are a few points to consider when looking for your next pair.

First and foremost, the goal is to find a shoe that is comfortable. Nigg et al. suggested in a 2015 article that we would do best to select a shoe that does not interfere with the way that our foot prefers to move most naturally.

Begin to break in a new pair when one pair is about halfway worn out. I like to use the newer shoe for longer runs and the older shoe for shorter runs or nasty weather. Most shoes are going to be very worn out by 400-500 miles. However, permanent changes in the cushioning material are evident within just 200 miles. Newer or injury-prone runners may not be able to use a shoe as long as an experienced runner or one that is less injury prone.

Try a ton of different models and brands when deciding on new shoes. The concept of using inner arch height as the indicator of whether you need a cushioned, stability, or motion control shoe is very controversial in the research. Sure, if you traditionally run in a certain shoe type and have no problems, then keep on with the same pattern. If whatever shoe you use seems to never be comfortable, feels too stiff, not stiff enough, too flat, or too high, then check out the other options that are available.

“Pronation” is not a bad thing. Everyone’s foot should pronate for the purpose of shock absorption. Individuals having lower inner arch heights pronate similar amounts to individuals with higher inner arch heights. Do not feel obligated to “stop” pronation with foot orthotics or stiffer shoes. That concept went out in the 1990s. Let your foot do the job that it was designed to do.

Remove the footbed liner of the shoe and place your foot on the liner. Ensure that your foot is fully surrounded within the perimeter of the liner.

Before you put the shoe on, try this “break test.” With two hands at each end of the shoe, compress the heel and toe of the shoe toward each other. The shoe should flex in the region of the forefoot. The forefoot will often have a cut in the sole that aligns closely to the joint at the base of your big toe and ball of the forefoot, which allows the joints to extend easily at that point. You want that big toe joint to align with the hinge point.

Still with the shoe off, with two hands, one on each end of the shoe, twist the shoe like you are trying to wring water out of a rag. There should be some motion allowed here. A shoe that barely twists at the front is not going to move well with your forefoot. At the same time, you want some, but not a ton of motion at the midfoot.

Sit the shoes side by side on a flat surface and compare how they rest on the surface. Check them from behind and from the front. They should be mirror images of each other. If one seems to be tilted differently than another, find a different pair. The heel cup should be centered over the sole.

Check the fit with your usual foot orthotic devices in place. Do keep in mind that most foot orthotic devices have an additive effective to the stiffness of the shoe. In other words, a stiff orthotic within a motion control shoe is heading toward overkill. You could use the motion control shoe independently or you may develop a similar stiffness from pairing the foot orthotic with a stability or cushioning shoe.

Over-the-counter orthotic inserts are not a necessity. I’m a big fan of letting the foot do the work it was designed to do, if at all possible. A lower arch height is not an absolute indicator that you need a foot orthotic. Imagine that foot structure is on a bell curve of normal where those on the tail ends of the curve have a foot shape that would benefit from the additional help of a foot orthotic. And inserts may raise the heel more than the forefoot, adding another layer of material that will contribute to changing calf muscle demand and altering ankle position. That shoe with an original 8 mm drop ends up becoming a 12 mm drop with that “arch support.”

Fit your shoes to allow for space of the longest toe and longest foot. Some folks have such a difference of foot length that they should actually buy two different sized shoes. Aim for 1/2-inch between the end of the toe and the end of the toe box.

Wear your typical socks during the fit session. (These better not be cotton or we really need to have a talk).

Please let me know if you have any questions at derek@mountainridgept.com. Thank you for reading!

Last year during marathon training, when I ran more than 15 miles, my legs would begin to have a lot of pain. Is there anything I can try to help lessen my leg pain when running high miles?

As far as the leg pain goes, I’m going to answer this question specifically about training and the muscles themselves. Hopefully it’s not the joints causing pain and I especially hope it’s not generated from nerve structures. Without seeing an individual’s running technique or knowing anything about their training history, some things I expect to help would include:

1. Strength training the quads, hamstrings, calves, and gluteals. A period of higher reps with light to moderate resistance and a period of lower reps against a high resistance are both useful. Performing higher reps against a moderate resistance to the point of failure can be very helpful in improving the resilience of a beginner or intermediate marathoner’s muscles. Hammer the quads with lunges, the hamstrings with dead lifts, and the calves with bent and straight knee calf raises. Performing enough reps to cause failure can promote great changes.

2. Self-massage the quads, hamstrings, calves and gluteals. A supple muscle is better at absorbing loads. This also helps relax the more irritable areas in the muscle that some people call “knots” or trigger points. In my personal experience, it prevents cramping that is associated with fatigue. Rolling with a foam roller, tennis ball, lacrosse ball and a massage stick are all common and useful depending on the location.

3. Address any running technique issues. Over-striding, for instance, can kill your quads early. It is also common for newer runners to lack the understanding of how their bodies should absorb impact. A few (4-8) strides of 25-50 yards in your bare feet one to two times weekly can help most runners gain a little insight into proper force absorption. Grass and turf are nice for this. You shouldn’t sound like a herd of cattle when your foot hits the ground. Speedwork can improve running technique as well, so….

4. Increase your speedwork. For a beginning marathoner, one speed workout per week is sufficient. Part of the leg discomfort may simply be from the byproducts of rapid glycogen breakdown in the muscle. The best way to become used to cleaning up those byproducts is to train at a higher speed on a frequent basis. That means you should purposely make the muscles hurt in short, hard runs so they find the pace of a longer run easier to sustain.

5. Continue to emphasize longer runs every one to two weeks. If you have a three-month training block before the marathon, that’s at least six critical long runs, maybe even up to twelve. There is a huge and important adaptation time that must be considered when you are planning to run longer distances.

6. Don’t go out too hard. Better to start slow and prevent your body from quickly depleting the stored glycogen sugars. If you feel well at mile 12 and you are going 15 miles, then by all means pick it up a bit at that point. Make note of what you felt like throughout and adjust the pace accordingly in the next run. Long runs are all about aerobic base training, not speed or pace records, so there’s no shame in going super slow and even walking frequently to keep the stress lower.

7. Eat during the long runs. If you only have a few years of running experience, it is unlikely that you are burning your energy stores at the most efficient rate no matter your pace. So your best option is to eat during the longer training runs to insure a constant supply of energy. Even consuming 50 calories an hour can help tremendously, though you should experiment with taking in more, as long as your stomach tolerates it. Most people can consume at least 100 calories in an hour without distress if they are moving at a pace that is hard but sustainable for at least 90 minutes. Some do better with liquid calories, some with solids. Some people can only eat unprocessed foods while others can eat sugary gels until the cows come home. Experiment in training, not on race day. And start eating early in the run, by 30 minutes.

Let me know if you have any training and injury questions at derek@mountainridgept.com.

Anyone who exercises for an extended period is at the mercy of their stored energy and blood sugar levels. Glucose is the basic sugar circulating in the bloodstream and it is well controlled within a specific range for a healthy person. Stored sugar, glycogen, from your liver and muscles, can be used to keep the blood glucose regulated.

If your blood sugar decreases to lower levels during prolonged activity and can’t be stabilized, your brain will prioritize itself over anything else because glucose is its primary fuel source. This means working muscles are not exactly high on the list. You are in the process of bonking, otherwise known as non-diabetic hypoglycemia or exercise-induced hypoglycemia.

Risk of bonking increases with the following:

Longer duration of exercise

Higher exercise intensity

Exercise in a hot environment

Insufficient calorie intake during the day of exercise

Chronically insufficient calorie intake over a period of days

Insufficient recovery time from a prior bout of exercise or multiple days of exercise as it takes nearly a day to restore glycogen after it has been used (in ideal conditions)

Another recent episode of bonking

Dehydration

Limited prior exposure to depleting exercise

Athlete inexperience

Athletes are not always aware of the signs and symptoms of bonking until they become more dramatic. Some symptoms of the blood sugar drop are mental and others are physical. The initial cues can be subtle but the symptoms can progress to more severe levels rapidly. Many marathoners know this as the feeling of “hitting a wall” around mile 18 to 20.

When bonking, pace per mile might initially change by something small, like 15 or 20 seconds. But if the effort continues and no calories are consumed, you could easily slow by 1-5 minutes per mile or even more.

I’ve known many hard-working, well-trained marathoners that train months for an “A” race, doing tons of distance and maybe even trained up to 23-26 miles. They feel strong but depleted at the end of those long training runs but they train more slowly than they race. So by running faster in the actual race they burn through their energy stores sooner and completely crash despite decreasing mileage for several days in advance of the marathon. That’s tons of training wasted because they refused to learn to eat a little something in the marathon.

Bonking happens around the same point for most people because we all store similar amounts of glycogen that are used up at similar rates. It’s possible that years of training could allow someone to burn a greater percentage of fat for energy, but harder efforts always require higher glycogen dependence. And having run for just a couple years isn’t long enough to perfect a fat burning metabolism.

The signs and symptoms of declining blood sugar, in a general classification order of increasing severity:

Your job is to detect symptoms as soon as possible in order to keep your state from declining further. Ignoring the symptoms and hoping for the best is never going to end well. If you have signs and symptoms consistent with the green items, there’s a good chance you can pull things back together if you take appropriate action, though it won’t be a day of personal best performances.

A few experienced and lucky athletes might be able to come back quickly from the yellow zone but nobody is bouncing back from the red zone. Only the more stubborn people will even push themselves far into the yellow zone. It’s a super dangerous, slippery slope. Don’t do it. You can’t win against physiology.

Many people don’t have the motivation to put themselves deep into the pain cave, so they just automatically slow down in order to feel better when they feel uncomfortable and have persistent negative thoughts. Kudos to you for not being a ridiculously stubborn fool like some of us!

Simply slowing down may be sufficient to finish out the workout or competition. If you don’t want to slow down, then you need to eat something containing carbohydrates as soon as possible. Ideally this would be something with simple and complex carbohydrates. There are receptors in your mouth that detect sugars and just the act of eating can immediately reduce the brain’s stronghold on protecting you… from you.

But there’s a good chance that you need to slow down AND eat something, depending on how long you are planning to exercise. If you are bonking after 90 minutes and planned to be active for 3-4 hours then it’s going to be unreasonable to sustain the same effort without eating many more calories.

Three truths about bonking:

You have to learn to eat during prolonged activity, even though you often won’t feel like eating, or the bonk will occur.

If you don’t eat and your intention is to maintain both a high intensity and a prolonged duration of greater than 2 hours, the bonk will occur.

Bonking is completely preventable.

Thanks for reading! Please let me know if you have any questions at derek@mountainridgept.com.

This Labor Day weekend I was looking forward to a little trail time at Coopers Rock State Forest. Last year I didn’t have a great performance at this race, ultimately blowing up in the last mile. For such a small event (61 racers this year), the fellow competition can be pretty stiff. I just remember it hurt more than the average 10K. In 2015, my speedy high school cross country running neighbor exclaimed “that’s the hardest thing I’ve ever done” afterward.

No doubt, the course is difficult, primarily because of the elevation changes. At nearly 800 feet of gain, no one is going to set a new 10K PR. Additionally, the easiest section, Roadside Trail, is along the first mile and then it becomes more technical from that point.

Tough elevation profile

I expected that the switch to an early morning race time (9:00 a.m.) from last year’s afternoon time would be beneficial for performance. And it was. Sweat volumes were down 43% (exact figure gathered in a very scientific manner). The weather for running is fantastic in the forest now that September has rolled around and the humidity is dropping a bit. Fall can be the best time to run. Go outside!

Through my typical warm-up running I couldn’t seem to make my legs feel very powerful. This is entirely my fault for pushing them a little too hard earlier this week with weight training. They were not recovered and the soreness made that obvious. Not an “A” race but a slight bummer, nonetheless.

After the start, it didn’t take long for one racer to go hard off the front. Since he looked young, I opted to let him go alone at that quick pace, hoping he would explode on the brutal climb at mile 4 known as “The Wall” or “Vomit.”

I lost sight of him by mile 1 and promptly rolled my left ankle off the side of a small rock. It popped and hurt a little but wasn’t the worst roll ever, so I kept running. Maintaining a higher turnover cadence minimized the damage, thank goodness. Yes, I hurt myself on the easiest section of the course.

Tip #1: Look at the exact spot where you want your feet to land. Don’t look at anything you don’t want to touch. If you look directly at that slippery root or rock, you are probably going to step on it. That can be both good or bad. Set your gaze just beyond the bigger obstacles.

My splits were more consistent this year than last because I conserved in the first mile, so I tried to focus on an even effort now that I was alone in no man’s land. The legs were just not getting it done and never did come to life.

The descent that begins after mile 2 is lengthy, as it lasts until mile 4. It’s not super technical but it is long enough that it will take a toll on the leg muscles. But it is fun and there are a couple of logs and streams to hop. Think I jumped a stump in there too.

Tip #2: A course like this does not lend itself to obtaining even mile splits. You have to be good at reading your effort level or learn how to use a heart rate monitor to control your effort. With technical trails, you are likely to run at least 1-1.5 minutes slower per mile than a road 10K. And that’s just on the flatter or rolling sections. Hill climb miles will take an extra 2-3 minutes per mile, if not more.

At mile 4 the real climbing begins. Now that the descent has deadened your quads and so many miles have passed, we head up The Wall, where I always remember being unable to ride on a mountain bike as a teenager. That’s because it’s between 15 and 20% grade for the first tenth of a mile. But the whole climb is nearly a quarter of a mile long.

Tip #3: Nearly everyone walks on the steepest climbs of trail running. Anytime you choose to walk, walk with a dedicated, driven purpose. The walking is still going to allow a little recovery from running, even if you push your pace. So many folks hunch over, give up, and can’t even take a deep breath when they decide to walk.

There’s a moment of rest to be had while descending Rhododendron Trail, but it’s short-lived as the final 1.5 miles of the course account for at least 400 feet of the course’s elevation gain. This is where I was really suffering last year. I had conserved better this year and could actually push the effort a little bit.

Tip #4: Save a little something extra for a course that is known to have a large climb near the finish. You will always be more tired at that point than you think you should be.

Tip #5: Wait, you didn’t know there was a climb at the finish? Doing a little research can go a long way. Just ask around the group. Someone will be familiar with the area and course. I knew there was a long climb last year but I didn’t realize it would be so persistent and unforgiving.

About a half-mile from the finish the course drops into an awesome area known as Rock City where sandstone boulders are a gigantic 20-30 feet tall and large enough to contain a trail network. It’s a favorite for runners and hikers, as well as the average passerby.

A couple greenbriar snags later, at the finish, I was thrilled to cut a big chunk of time off of my attempt from last year. I would have been more happy to run this as a 20K since my old man legs haven’t done any speedwork lately.

Standing at the finish line, I saw many racers completing the event with blood on their legs, on their arms, and even on their faces. These trails are no joke.

Tip #6: You can catch a toe on anything that sticks up in the trail, at any time. Many accidents happen when you tire a little, let your guard down, and aren’t picking up your feet as high. But even with excellent vigilance and balance, falls are common to trail running.

Big thank you to Mark and Eleanore Jones who always do such a great job of directing these endurance events at Coopers Rock. As runners themselves, they get it done right. What a great way to support the Coopers Rock Foundation.

I recently had the pleasure of meeting with a few parents and students on the Mountaineer Middle School cross country team as they were getting ready to start their season. I wanted to touch upon a couple questions that were asked because I imagine multiple people, of any age, can gain value from the answers.

Question #1

One runner asked if there was anything he can do to change the fact that his legs become tired far before his breathing or heart feel fatigued during a race. This typically occurs for him halfway through, but then about 75% of the way in, he is able to overcome the leg fatigue to finish strong. This was especially problematic for him on flat courses.

First off, I expect this to occur to some extent, especially in a younger, less-trained, or less-experienced group of runners. It’s common to feel good and be excited, so you barrel off the line. It happens to everyone from ultra-marathoners all the way down to 400-meter runners. Let’s say we apply an old coaching philosophy: run the first one-third with your head (smarts), the second one-third with the legs (fitness), and the final one-third with your heart (desire).

Sounds like this young man has the final portion down but there’s a good chance his first one-third is faster than ideal. Young runners are notorious for going out too hard, which makes the later stages of the race more uncomfortable. One problem is that in a cross country race these kids almost always have to do this because the area available to run shrinks down to a narrow path where real estate is at a premium.

So let’s just leave the “going out too hard” concept alone for now, because it’s not a road race where you can easily pass people. This student has to go a little harder than ideal in order to be competitive in a 3K race. In order to get through that middle one-third, there will be discomfort, but it’s the point where the person with the most fitness will excel because he can recover on the move from the slightly too quick first third. Plus, there is research at the 5K distance to show that starting out 3-6% faster than average total race pace results in faster overall times. (http://www.ncbi.nlm.nih.gov/pubmed/17149992)

I suggested that this young man focus on his cadence just prior to the point where he feels the leg fatigue. As we fatigue, our cadence tends to slow down. There’s a good chance he ran the first one-quarter to one-half mile with a quicker cadence but then settles into a longer, more loping stride. At the same time, the pace drops a bit. To take some of the stress off of the painful quadriceps and calf muscles you can decrease your stride length and increase your turnover.

One good thing is that cross country around this region generally means terrain changes. Hill climbs are the perfect time to increase cadence. This is easily achieved by pumping the arms more quickly. The legs and arms will always be in sync. If you think about increasing speed of arm movement, the legs must follow. The steeper the incline, the shorter your stride should become. A single leg turnover of 96 per minute going up super steep hills wouldn’t be crazy. A gradual incline might demand something in the range of 88-94 foot strikes per minute.

Even on a flat course you can make the conscious choice to fluctuate your cadence. It’s a nice distraction, if nothing else. Hopefully it is done in a preventative manner prior to the leg muscles feeling highly fatigued, but better late than never. A flat cadence could be more like 84-90 per minute. On downhills it could easily drop into the upper 70s.

One key to all of this is to experiment and train with the cadence fluctuations. It’s not going to come naturally in a race if you’ve never done it before. Instead, it’s just another burden to add stress and you might just forget to do it. Plus you are more likely to waste energy if it’s extremely new. Your nervous system has to practice the quicker turnover in order to make it efficient.

The more recent GPS training watches, like the Garmin Forerunner series, have a cadence measure. It’s worth paying attention to this number while running. And if you upload the data onto the Garmin Connect website or other training sites, you can see where the cadence tended to slow down or speed up during training or racing. It wouldn’t be surprising to see the turnover slow just as the point of heavy leg muscle fatigue approached.

Here’s a fun little experiment. Go find your favorite hill for repeats. Something at least 100 yards long and hopefully more gradual. Run it hard once with your normal turnover rate. Run it again while trying to maintain the same pace but while really trying to stretch your stride out extra long with a slow turnover. Do it a third time while focusing on a super quick turnover, again maintaining the same pace. Now there’s going to be some fatigue by that point, no doubt, but can you feel the difference in the demands that it places on your body?

Question #2

One parent wanted to know if their child needed to drink a sports drink before their cross country meets. Not that I have a perfect diet, but I’m not a big fan of mainstream sports drinks in the first place because they are often loaded with tons of processed simple sugars.

In shorter races like the 3K or 5K, the runner is primarily relying on stored energy, glycogen, within the muscle fibers. For a short event there should be plenty of that stored glycogen available unless you haven’t eaten for several hours or maybe you exercised really hard in the 1-2 days prior.

Some sports drink sugars, like fructose, are known to cause stomach upset if consumed before, during, or after exercise. That’s not very conducive to performance (or a pleasant child, for that matter.)

A snack or lunch two to three hours prior to the event should be sufficient for topping off the calories needed to get through these shorter events. Drinking water after that point is plenty sufficient.

I’ve seen parents “grasping at straws” when their child has succeeded in the main season and is headed to a big event, like a state meet. Instead of sticking to the same nutritional plan that the runner had used all season, the well-meaning parent has their child drink some new mysterious sports drink 15 minutes before their race. Maybe the runner tolerates it. Maybe they don’t and fail miserably. That’s the equivalent of playing with fire in my mind. Go with what has worked in the past.

The one instance where I can think a sports drink might be appropriate is if the runner had missed their lunch or breakfast for some reason. And that should not be happening. Plus, the runner has hopefully tried the same sports drink on an earlier occasion. It might be smarter to have the individual carry an emergency “real food” snack. That’s a good idea anyway because you should avoid becoming hungry on race day.

Do you have any questions about training, racing, recovery, or injuries? If you do, shoot me an email at derek@mountainridgept.com and you might get to see the answer in a future blog post.

There are two ways to go wrong with the “wait and see” method. In the first, an athlete, believing “rest” is the critical factor in injury recovery, takes a large amount of time off after the initial onset of pain. When they do finally return to activity, having had no pain for a day or two, they often start out with way too much intensity or time. If you haven’t run in 2 weeks, then the first run back should not be a 5-mile excursion. In fact, it should be quite brief. And of course, instead of running an easy 10-minute mile pace, your legs are fresh, so 7- or 8-minute miles seem suddenly more comfortable than ever.

Few people ever follow this advice because there is a misconception that rest fixes all. (Same assumption goes for surgery fixing everything, but that’s another story.) And then the athlete can’t figure out why the injury came back a couple weeks later. Of course that recurrence is followed by yet another solid block of rest and the cycle of inconsistency continues. The body WANTS to heal. I find that to be pretty amazing. The key is providing consistent exercise loading to not only maintain fitness but to improve tissue integrity.

Don’t get me wrong. Rest is extremely important in recovery from training and from injury. But it should all be administered in appropriate doses. If you know, deep down, that rest is powerful then you should be doing a better job of resting prior to any symptom onset, not waiting until something hurts. Rest should never be considered as the primary method to address injury.

In the second scenario, the athlete ignores their initial injury symptoms and continues to exercise, waiting for the injury to spontaneously resolve. This can stack too much stress onto an already injured area. It’s often easy to do with running, because so many muscle and tendon injuries actually feel better once the tissues have warmed up a bit. That’s why overuse injuries are so deceiving. If the pain is gone while exercising, you must be doing okay, right? Well, no, it’s not that easy.

If we were to classify the onset of pain from overuse injury, there’s typically a progression:

Pain only after exercise.

Pain during exercise, though not at a high enough level to stop.

Pain during exercise that does limit time or performance.

Pain so severe you absolutely cannot exercise.

Athletes often become stuck at the second phase. Sometimes for months at a time. When they approach the third phase, they suddenly become desperate and finally begin addressing the things they knew were problems in the first place. Don’t be “that guy.”

Consider yourself only as good as your last successful, pain free run. Best not to worry about progressing when injured if you want a long career. Best to worry about preventing regression and working on your known problem areas, like hip strength or ankle range of motion. If you don’t know where your problem areas are, seek guidance from a movement expert.

Relying on pills and injections:

Everybody loves a “quick fix.” Some like it because it requires no real effort or time to take a pill. Others like it because it might reliably take pain away and they are unaware of any other treatment option. For some people, they feel they don’t have time for proper injury treatment. In any case, once the pain decreases you expect to go on about your training as soon as possible without any other care.

But think about this for a moment. If a mechanical stress led to your painful tissue damage, then there’s good reason to focus on a mechanical solution when there is one available. Medicines aren’t typically designed to alter mechanical stress. Let’s say the medication did stop the pain. Just because the pain stopped doesn’t mean the underlying problem went away.

Unfortunately, rarely is the proper solution a quick one. Pills and injections are not a reasonable long-term solution. Just like appropriate doses of rest, NSAIDs and corticosteroid injections certainly have a place in treatment. But they are not a valid long-term option for relief of overuse damage.

Blaming the shoes:

I am guessing the shoe industry is at fault for this perception. It’s not about the shoes. Overuse injuries are likely to be caused by a variety of factors but most frequently by training errors. This means your intensity was too high, distance too long, or the rest was insufficient. (This is the third time I have mentioned rest!)

Even the biomechanical flaws that I might address in the clinic take a back seat to poor program design. We are highly adaptable. Each running technique is known to stress specific tissues.

What might be considered horrible running technique can be safely performed if you progressed slowly enough and were strong in all the right muscles, tendons, and ligaments.

Summary:

Like the cause of the injury, resolution should be a multifactorial approach. The trick is going to be exercising within the tolerances that the injured area allows while also working on any related deficits. Back the distance and pace down.

It’s unreasonable to believe that you don’t have mechanical deficits somewhere that contribute to the injury. Training errors in speed and time just make those flaws more prominent. You must look outside the area of injury. The body relies on an integration of systems for movement so if just one system fails at its job then you have a problem. And that problem probably isn’t where your pain is occurring. Is your balance perfect? Movement awareness stellar? Posture perfect? Strength out of this world? Have the joint motion of a 10 year old? Unlikely. Bring home those new shoes and get to work on the right things.

To finish up this series of posts on strength training, let’s cover a few examples of exercises that you can incorporate into your routine. Most of the videos focus on the lower body and trunk, though you should certainly work the upper body. With several of the lower body exercises, you can integrate in an upper body component to add an additional challenge. The Mountain Ridge Physical Therapy YouTube page contains several variations of these exercises, from basic to advanced versions.

Please let me know if you have any questions at derek@mountainridgept.com. If you enjoy reading these articles and applying the information to your training, please “like” the Mountain Ridge Physical Therapy Facebook page.

Why not strength and plyometric train? That’s a better question. My personal excuse is that it’s not as fun as running, partly because it’s not done outside and nowhere near the woods. I’d rather move me, not a dumbbell. Although I’m sure some would say by moving myself I am indeed moving a dumbbell. *Sigh*

For myself and many other runners, strengthening is a necessity if you want to run long, hard, or into old age. I will gladly give up 3-6 junk miles every week to take the time for this type of cross training. Strength training gets me to a point that makes the other runs more enjoyable. How does it improve my running enjoyment? Largely because I stay less injured overall, my back doesn’t hurt during long runs anymore, I recover quicker, and my legs never get that completely destroyed feeling in long races that they once did.

I would argue that running itself is a series of plyometrics. (The Merriam-Webster definition of a plyometric activity is “exercise involving repeated rapid stretching and contracting of muscles”). Plyometrics are just high speed strengthening.

Here are a few reasons runners should consider strength training:

1. Strength training improves performance. Every runner can benefit from strength training. Competitive trail runners, marathoners, and speed demons who compete at any distance could reap very significant gains. At the same time, the less competitive folks running just for fun could benefit too.

The mechanisms of improved performance can be attributed to any one or a combination of the following factors:

Having a strong core and hips takes unnecessary trunk motions out of the equation. You can then move the arms and legs more quickly and with greater force without disrupting the stable base. I noticed this in the 2016 women’s 10,000 meter U.S. Olympic trials. Molly Huddle maintains a very stable trunk posture. As a result, there is less energy wasted during the early and middle part of the run and that energy can be put to use in the closing laps. And at that point many of the competitors are flailing anyway.

Increased force production

As far as the prime movers of the legs go, if you want to move faster while running, your options are to:

increase turnover while maintaining the same muscle force output,

increase force from the muscles while maintaining the same turnover, or

increase both muscle force and rate of turnover.

Strength (and plyometric) training is a great way to teach your larger leg muscles to generate that force in an efficient manner. Many of the changes that we would refer to as increased strength are actually the result of the nervous system’s ability to refine how the muscle fibers fire. It’s definitely not all about making the muscles bigger. By increasing the ease and efficiency of force production, you can become faster.

Greater total muscle strength can lead to greater strength endurance capacity. Strength endurance is concerned with the ability to generate a certain force for a prolonged period. In other words, after strength training for a few weeks I can make a muscle produce the same or greater force for a longer period of time before it begins to fail. This is a huge benefit if you have reached the limits of what your fast-twitch muscle fibers are willing to perform with standard running interval training techniques.

Racing and hard efforts can rely heavily on the fast-twitch muscle fibers, and slow endurance training does very little to train these muscle fibers because slow training is primarily using slow-twitch muscle fibers. You can only perform so much high intensity interval work while running so strength training is another way to stimulate these muscle fibers. By regularly training the fast-twitch muscle fibers, you can improve movement economy and improve fatigue tolerance. Better fast-twitch muscle fiber use will help you when bridging a gap in a race, moving at faster speeds, and climbing hills.

2. Strength training can help you prevent injury. There is research citing decreased injury incidence in athletes with consistent strength training routines (http://bjsm.bmj.com/content/early/2013/10/07/bjsports-2013-092538.abstract). Stretching, on the other hand, has no consistent research support in injury prevention. For one, as mentioned, proper strength training helps to increase hip and core stability so that the legs and arms are moving on a stable base. My theory would be that it’s mostly the strength, stability, and muscular endurance of the hips and core that help to keep a runner away from injury though it's certainly important to train the rest of the leg as well. This is where many runners have the wrong idea of what strengthening should really be about. The primary objective is to take the unnecessary motion out of the system in order to reduce the injury causing “slop.”

3. Strength training can help you recover from injury. Often, strengthening of specific muscles is a vital component of any patient’s injury recovery in my clinic. In the case of both injured and uninjured tissues, the intention is to rely on these primary concepts:

Improved structural integrity of muscle, tendon, ligament, and bone, and

Improved strength and neurological activity in weak muscles

4. Strength training changes your perspective on higher training intensities. If you can perform enough repetitions with a high resistance that you reach a point of true muscle failure, you begin to understand what it’s like to really push that extra bit of effort from yourself. That can make a finish line sprint or track workout feel a little easier, for the muscles at least.

5. Strength training helps decrease age-related strength loss. Aging causes a loss of the fast-twitch types of muscles fibers and their associated nerves. Frequently demanding work from those muscle fibers slows the rate of loss. Nobody wants to lose the strength necessary to do daily tasks but I assure you that it will happen if you let it. I didn’t think about this until I started approaching 40 years of age (and the girls stopped whistling at me.)

6. Increasing strength makes you a generally healthier individual and a well-rounded athlete. There’s nothing better than being able to confidently lift a 50-pound bag of potting soil from the ground without fear of hurting your back. And being able to randomly and confidently play a pickup game of {insert any sport here} is pretty awesome too.

7. Variety and changes in your training program prevent burnout and staleness. The same old, same old becomes dull and demotivating for most people. There is so much variety possible with strength and plyometric training that it can really freshen up your outlook.

8. Strength training can boost you through a performance plateau. The repetition associated with some endurance training programs will inevitably lead to a plateau in many athletes. In order to bust through the plateau you need a new type of training stimulus. Resistance training can be that stimulus if delivered correctly over a 4-8 week period of time, especially if you add the plyometrics and change up your running interval program.

Please let me know if you have any questions by emailing me at derek@mountainridgept.com.

Middle and long distance runners have a long history of neglecting proper strength training, partly because they don’t enjoy it as much as running and partly because of the myths surrounding the concept. Those myths need to be broken.

Myth #1: Strength training will make my muscles bigger and then I'll be heavier.

You will not automatically gain weight and become huge because you start strength training. In the strength training world this increase of muscle size is referred to as “hypertrophy.” Many runners don’t want to gain size because that’s extra weight to carry in every step. The reality is your body will best adapt to the stresses you place on it most often. If you run once per week but lift weights on 3-4 days then yes, you might bulk up. But if you run 3-4 days each week and strength train during just one day then you aren’t going to add muscle mass. Age, sex, and genetics each play a role in gaining muscle size as well. And the type of strengthening stimulus matters. Larger muscle size tends to come from an emphasis on multiple sets of an exercise using a weight that is 50-75% of your one repetition maximum.

Myth #2: Strength training requires weight equipment.

Fortunately, resistance training does not always require equipment. It is possible to use your bodyweight to provide a decent stimulus for many of your muscle groups. For instance, it is critical to emphasize hip strength and core stability in any runner’s program. This type of strengthening requires nothing more than challenging positions that start with a basic plank. Advancements of difficulty can be made by isolating the muscles you are trying to work, working only one side of the body at a time, or adding stability challenges (i.e. balance).

Myth #3: Strength training requires special machines.

It definitely does not require special machines. In fact, I am a huge proponent of avoiding machines altogether. Machines are inferior to free weights in so many ways. They do not challenge the parts of your nervous system that monitor your body’s stability and positional awareness. Machines also restrict your range of movements. Freeweights can moved through any available range. And for those that like to workout at home, free weights can be cheaper and take up less space than machines.

Myth #4: Strength training means I have to workout inside a gym.

Strength work doesn’t always have to involve an indoor gym. For running, steep hill repeats with an intentionally slow, bounding cadence can engage a large number of fast-twitch muscle fibers in the hips and legs. It’s those fast-twitch muscle fibers that can improve your sprint speed, surge speed, and overall pace in races like a 5K. The scenario is the same with plyometric training as you don’t need equipment or a special location to bust out a few quick jumps or hops.

Myth #5: Strength training will slow me down.

If done correctly, strength work will not slow you down and actually has the potential to make you faster. In one recent study, even when very heavy amounts of weight were used (3-4 sets of 4-10 repetitions to failure), female runners maintained their race speeds after 11 weeks of training. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783109/) In application, I would never expect a competitive or recreational runner to train with that heavy of a resistance for such a tremendous amount of time. However, it is good to know that even after several weeks of heavy weight training these women sustained their speed. I would expect runners of any ability level to spend their time performing supplemental work to gain hip and core stability and fatigue resistance of their primary movers (hamstrings, quadriceps, calf group).

Myth #6: I won’t gain anything from strength training only one or two days a week.

As little as one day per week is sufficient to have a positive impact on strength and strength endurance. Some athletes think that strength training has to occur at a high frequency to result in a change. That’s simply not true. Working hard on your weakest areas just one to two days each week can have a tremendous impact. If those muscles were minimally challenged beforehand, then any stimulus greater than their normal level of activity is going to cause a positive change. Even if you prevented just one injury, it would be worth the extra effort of as little as 30 minutes each week.

Next week I’ll dive into the benefits of adding strength training to your running program. In the meantime, if you have any questions, email me at derek@mountainridgept.com.